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Contact Information

JENNIFER LAI MCCORMACK, RN
6006 43RD AVE
1D
WOODSIDE, NY11377-4977
 Phone: 917-558-6832
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
Indicates primary specialty

NPI Profile & details for JENNIFER LAI MCCORMACK · (Female)

NPI # 1740694959
Status Active
Credentials RN (Registered Nurse)
Entity Individual
Enumeration date 06/16/2014
Last updated 06/23/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 589522-1
Hospital affiliation(s)
  • JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON - (Acute Care)
    75 NORTH COUNTRY ROAD
    PORT JEFFERSON, NY 11777
  • PECONIC BAY MEDICAL CENTER - (Acute Care)
    1300 ROANOKE AVENUE
    RIVERHEAD, NY 11901
  • ST CHARLES HOSPITAL - (Acute Care)
    200 BELLE TERRE ROAD
    PORT JEFFERSON, NY 11777
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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